• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1224-1229
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• 2003

Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.383-390
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• 2008

Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.

• Korean Journal of Soil Science and Fertilizer
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• v.31 no.3
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• pp.277-284
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• 1998

The raw food waste of Korea contained markedly high sodium chloride and such high sodium chloride concentration in the soil is a factor limiting plant growth and impairing soil physicochemical properties. This study was carried out to assess the effect of NaCl-containing compost on the growth of lettuce(Lactuca satjva L.) and on the soil chemical properties. For the experiment, six treatments applying 0, 0.5, 1, 3, 6, and 9% NaCl-containing composts at the rate of $20Mg\;ha^{-1}$ were conducted established in a greenhouse. Growth measurements, chemical analysis of lettuce foliage, and soil chemical properties after the harvest were investigated. Lettuce yield in the treatments applied to composts over 3% NaCl was gradually reduced and mortality of lettuce as well as Na concent ration of lettuce foliage progressively increased with successively higher NaCl concentration of composts. With an increase of NaCl concentration of composts, the values of ESP and exchangeable sodium concentration in the surface soil were significantly increased. Especially, ESP of surface soil in the treatment incorporated with 9% NaCl-containing compost after the harvest attained by about 15, suggesting that sodification of surface soil under a greenhouse condition can occur when the compost over 9% NaCl is applied to soil. In conclusion, the application of over 3% NaCl-containing compost at the rates of $20Mg\;ha^{-1}$ can cause undesirable influences in plant growth and also the treatments of over 6% NaCl-containing composts can create conspicuous deteriorations in soil chemical properties in the current year.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.150-160
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• 1999

Background: The CREST syndrome is an indolent form of progressive systemic sclerosis. Although its clinical progress is indolent, pulmonary hypertension(PH) associated with CREST syndrome have grave prognosis with over 40 percent mortality rate at 2 year follow-up. But the pathogenesis of pulmonary hypertension in this disease is not known, and classified as either primary or secondary PH. Clonality of endothelial cell proliferation in plexiform lesion is a molecular marker which allows distinction between primary and secondary PH. We performed this study to know whether the PH associated with CREST syndrome is a variant of primary PH or is a secondary PH. Methods: We assessed the X-chromosome inactivation based on the methylation pattern of the human androgen-receptor gene by PCR(HUMARA). Endothelial cells in plexiform lesions from female patients(n=3) with PH associated with CREST syndrome were microdissected from paraffin blocks. Vascular smooth muscle cells and lung parenchyma were also microdissected for clonality studies. Results: The proliferating endothelial cells in 14 plexiform lesions were all polyclonal. Similarly proliferated smooth muscle cells from 5 vessels with medial hypertrophy were also polyclonal. Conclusion: These results suggest that the pulmonary hypertension associated with CREST syndrome has different pathogenesis from primary PH and to be classified as secondary PH.

• Journal of Gastric Cancer
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• v.8 no.1
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• pp.27-34
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• 2008

Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.112-132
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• 1975

When Korean family planning services began as a part of the National Policy in 1962, the annual population growth was 3.0%. This growth rate has been decreased to 2.0% during last ten year period. And it seems imperative that all hospitals, as well as related organizations, should participate in family planning in order to contribute to achieving the National goal of 1.5% population growth by 1976, the end of the Third Five Year Economic Development Plan. Nurses should be considered the most important human resources in charge of the core of family planning services in any setting. For the family planning services in the general hospital setting, nurses as a core members contribute much as change agent, motivators, counsellors, educators etc. A nurse can work with patients and their relatives when she is equipped with relevant knowledge and skills. Fur the more family planning cannot be ignored even in hospital setting where more comprehensive nursing care is needed Thus, the general objective of this study is to provide baseline data for better programming of In-service education in family planning so that effective hospital family planning nursing services can be made a part of comprehensive nursing care contributing to the national population program and human welfare. In order to meet the general objective, this study has the following specific objectives : 1. To find out the general characteristics of the clinical nurses working in Y Hospital 2. To evaluate their attitudes and practices of family planning 3. To assess their knowledge, attitudes and practices of population and family planning as professional nurses. 4. To examine and compare data collecting methods for the planning of an In-service Educational Program 5. To explore the contents to be included in this In-service Education Program. The study population randomly selected one hundred nurses working in Y Hospital A cross-sectional survey with questionnaires developed for this study was chosen for the study method. To collect reliable data, the questionnaires were distributed to and answered by the study population in a controlled situation. X²test and t-test was employed in analyzing the data. The findings of this study are as follows: 1. Y Hospital nurses had a lower ideal number of children (X=2.02) and showed no strong preference for male children, and 74% of them expressed the desire to use permanent methods of birth control 2. of this thirty Y Hospital nurses who were married 66.7% stated they were already practicing contraceptive methods. Most of them preferred male methods of contraception. 3. According to objective evaluation about knowledge of various aspects of population and family planning, respondents from collegiate programs significantly knew better the subjects on the average than did respondents from diploma programs of nursing. 4. There was a marked difference in the results of self-evaluation and objective evaluation in their family planning knowledge. It was found that the self-evaluation family planning knowledge seemed to be unreliable. Accordingly, the objective test methods appeared to be more reliable in the evaluation of knowledge levels. 5. The subject areas needed to be included in In-service education for the Hospital family planning services in Y Hospital are 1) rhythm methods, 2) tubal-legation, 3) family planning effects of contraceptives, 4) population growth, 5) demographic traction, 6) population structure and 7) infant mortality facts. In addition, 1) various oral contraceptives, 2) basal temperature method, 3) laparoscopic female sterilization, 4) interfering factors of family planning, 5) anatomy and physiology of the female reproductive organs were additional areas to be taught to respondents from 3-year diploma schools of nursing. Demographic transition was one subject area in which the four-year graduates need further study. 6. Population problems guidance and counselling in family planning instruction in the theory and practice of contraceptives should be included in future In-service Education Programs in order to provide more effective hospital Family Planning Services, stated 77.0% of the respondents.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.334-345
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• 2001

Background : Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). Methods : The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. Results : Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT > $37^{\circ}C$, 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. Conclusion : Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.1007-1015
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• 2002

Purpose : The aim of this study is to find a method to diagnose and treat children who showed benign hemophagocytic histiocytes in bone marrow examination. Methods : We analyzed the clinical data of thirty patients retrospectively who showed benign hemophagocytic histiocytes in bone marrow examination from January 1995 to November 2001 at Keimyung University Dong-san Hospital. Bone marrow histiocytes were classified into a few, some, and many according to the number of histiocytes comparing with the white cells. Results : The age of thirty patients ranged from two months to 15 years. The median age was 5.6 years with male predominance(2.3 : 1). The most frequent clinical manifestation was fever; others were respiratory symptom, hepatosplenomegaly, lymphadenopathy and skin rash(in order of frequency). Common laboratory findings were leukopenia, thrombocytopenia, anemia and abnormal liver function test. Infection was present in 30 patients; causative organisms were documented in 15 patients, and bacterial infection was more common. Epstein Barr virus was the cause of infection in four patients. Bone marrow examination showed a few(20.0%), some(75.0%) and many(30.0%) hemophagocytic histiocytes. Combination immunochemotherapy including immunoglobulin, steroids and cyclosporine were helpful in 22 out of 30 patients. The mortality rate was high in young patients who showed some to many hemophagocytic histiocytes. Conclusion : Bone marrow examinations and early detection of histiocytes will be helpful in children who have fever, hepatosplenomegaly and abnormal liver function test. Immunochemotherapy were helpful and further investigation will be needed for the detection of the relationship between the bone marrow findings and prognosis.

• Parasites, Hosts and Diseases
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• v.28 no.3
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• pp.143-154
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• 1990

Observations were made on the differences of cell-mediated responses in mice of three infectiorl groups di여erently scheduled in their severity with pathogenic Acanthamoeba culbertseni. Infections were done by dropping $5{\;}{\mu}l$ saline suspension containing $3{\times}10^3,{\;}1{\times}10^4,{\;}or{\;}1{\times}10^5$ trophosoites, respectively. Amoebae were cultured anenically in CGV medium and inoculated into the right nasal cavity of CSH/HeJ mice aging around 6∼8 weeks, under the anesthesia by intraperitoneal injection of secobarbital. Delayed type hypersensitivity (DTH) responses in footpad and blastogenlc responses of mouse spleen cells using ($^3H$)-thymidine and the serum antibody titer were measured up to day 14 after infection, and natural killer cell activities were measured up to day, i after infection. The results obtained in this study were as follows: 1. The mice infected with $3{\times}10^3$ trophosoites showed mortality rate of 17%, and 345 in the mice infected with $1{\times}10^4$ trophozoites and 65% with $1{\times}10^5$ trophozoites. 2. In regard to DTH responses in all experimental groups, the level increased on day 7 and declined on day 14 after infection, but their differences could not be noted between infected and control groups. 3. The blastogenic responses of splenocytes treated with amoeba Iysates and lipopolysaccharides (LPS) showed no difference from the control group. The blastogenic responses of splenocytes treated with concanavalin A were declined significantly in the experimental group as compared with the control group, but the blastogenic responses of splenocytes treated with polyinosinic acid were not different from the control group. There was also no difference among three infected groups. 4. The cytotoxic activity of the natural killer cells was activated on day 1 after infection and declined to the level of control group on day 2 in all experimental groups. On day 5 after infection, the natural killer cell cytotoxicity was significantly suppressed as compared with the control groups. 5. The serum antibody titers of the infected mice increased after day 7, but there was no statistical difference between the three infected groups. In summary of the results, there was no difference in cell-mediated immune responses of three experimental groups scheduled with different infection intensities. But there was a significant difference in cell$.$mediated immune responses between infected and control mice. It is considered that cell-mediated immune responses should be involved in murine model infected with A. culbertsoni.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.183-189
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• 2005

Purpose: Despite the advance of medical science, the number of cancer patient have increased and the mortality rate is also on the rise. Therefore, a perfect cure for cancer is crucial, but the value and meaning of the remaining life for the patient are also becoming more and more important. The principal aim of this study is to examine the differences in the quality of life, physical and psychosocial symptoms according to the performance status of terminal cancer patients. Methods: We evaluated the performance status, demographical data, blood analysis and quality of life of cancer patients who visited the Department of family Medicine at Myoung-ji Hospital in Korea between September 1, 2003 and August 31, 2005. Their performance status (ECOG) was divided into two groups ($ECOG\;0{\sim}1/ECOG\;2{\sim}4$) and analyzed by ANOVA to see if there was a difference in their blood analysis and quality of life. A P value of less than 0.05 was considered to be significant. Results: A total of 104 patients were evaluated, among which 71 patients (23 male and 48 female) scored $0{\sim}1$, and 33 patients (8 males and 25 females) scored $2{\sim}4$ in the ECOG. The blood analysis showed that patients whose performance status was $2{\sim}4$ had lower levels of lymphocytes, hemoglobin, protein, albumin and sodium. The evaluation on their quality of life showed that the overall health status of patients with $2{\sim}3$ functional ability were poor (P=0.02). Also, from a functional perspective, these patients had poor physical (P=0.05) and role (P=0.01) scores, and in terms of symptoms, they showed a significant loss of appetite. Conclusion: If a patient's performance status was poor, levels related to certain nutritions were also found to fall in blood tests, thereby leading to an overall weakened state of health. However, there was no difference in symptoms except for a loss of appetite. In conclusion, it is most important to increase the appetite in patients with poor performance status.